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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 58715
Experience:  Cardiology Expert
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Hi, I am 31 years old and Male. For the past 5 months I

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Hi, I am 31 years old and Male.
For the past 5 months I keep having the following symptoms on a daily basis:
- Resting pulse in the 90's when sitting and goes up to 120 when standing, walking or with minimal exertion.
- An intermittent vibration or tremor feeling in my chest, most noticeable when I am at rest or falling asleep.
- Premature atrial contractions, mainly happen when I am standing. Sometimes these make me feel very dizzy.
- I often find myself feeling exhausted for no reason
The tachycardia is also triggered by minimal adrenaline, for example...when I am concentrating on something at work (office environment), I often find myself exhausted and I check my pulse and it's 100.
I have had the following tests
- 24 hour ECG: am in normal sinus rhythm.
- Blood tests to check Thyroid, Glucose, Kidney Electrolytes, all ok.
- Echocardiogram: normal
- 24 hour urine collection: normal
I am currently taking Perindopril 4mg for hypertension. My average Blood pressure with medication is 128/80.
I have also been prescribed Propranolol to be taken whenever i need it, and this does seems to help with the tachycardia.
I am not an anxious person and have minimal stress in my life. I do not drink alcahol or drink coffee.
I currently have a kidney stone but have been told by my doctor that this should not cause a fast pulse.
What are your thoughts on a possible diagnosis and what do you advise?
Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.
I think you have POTS
have you heard of this?
Customer: replied 3 years ago.

Hi, I have considered the possibility of POTS. I understand when with POTS blood pressure lowers when standing up. I have put this to the test and in my case my blood pressure remains the same. Is there another test to help diagnose this?

Is there any explanation for the vibrating in my chest?....Sometimes a PAC will trigger it and It kind of feels like a motor running sensation. The 24hour ecg did not pick this up though.

Also is there any supplements or foods that you recommend that will help reduce the PACs? (as long as they don't interfere with my medication of course)

Another thing I have been considering is the possibility of MVP. The echocardiogram did not spot this but I am wondering whether it can sometimes be missed?

I am due to have an MRI with contrast within the next few weeks, If there is an abnormality with a heart valve (such as MVP), would the MRI see this?....


Hi there Rio
I suspect the vibrating in the chest is a muscle spasm. This can happen from time to time. The heart gives electrical discharges and this might be causing a spasm
Dysautonomia is another possibility. It is like POTS but without all the features.
I would try zoloft 25 mg. It works amazing for POTS and other dysautonomias
Customer: replied 3 years ago.

Many thanks for the information.

One last question regarding MVP. Would an MRI detect this?


Yes, an MRI would detect it but echo is also very good Rio
I doubt you have it
please don't forget a positive rating. I appreciate it
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I appreciate the good rating.

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